What insurance policy changes affect HCPCS G0155?

There are 8 tracked policy changes affecting HCPCS G0155, including updates from CareSource, Aetna, UnitedHealthcare. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS G0155?

Payers that have issued tracked updates for HCPCS G0155 include: CareSource, Aetna, UnitedHealthcare, Kansas Medicaid (KanCare), Wisconsin ForwardHealth, Florida Blue.

How do I get notified when HCPCS G0155 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS G0155. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for HCPCS G0155?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

G0155 — Services of clinical social worker in home health or hospice settings, each 15 minutes: Insurance Policy Changes

G0155 Insurance Policy Changes

HCPCS G0155 is officially defined as "Services of clinical social worker in home health or hospice settings, each 15 minutes." HCPCS G0155 is referenced in 8 tracked payer policy changes from CareSource, Aetna, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS G0155 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

Massachusetts Medicaid: Prior authorization, HCPCS coding and member ID updates

UnitedHealthcare·Effective Jan 1, 2026

Massachusetts Medicaid has updated prior authorization requirements for home health services in Senior Care Options and One Care plans, clarified that Medicare certified home health services do not require prior authorization, and specified required HCPCS G codes for different home health services. Additionally, some members have new subscriber identification numbers that must be verified to prevent claim rejections.

G0155 Insurance Policy Changes

[Ohio] Hospice Per Diem Billing

[Ohio] Hospice Per Diem Billing

OfficeLink Updates - October 2025 notices and reminders (PDF)

Massachusetts Medicaid: Prior authorization, HCPCS coding and member ID updates

Massachusetts Medicaid: Prior authorization, HCPCS coding and member ID updates

KMAP BULLETIN: Fiscal Year 2026 Hospice Reimbursement Rates

ForwardHealth Update 2025-32: 2025 Hospice Reimbursement Rate Changes

Improve Behavioral Health Outcomes with Accurate Reporting